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    PH Should Be Performed Before Placing Into The Saline Commercial PH Test Paper With A Narrow PH Range Is Recommended

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    Janielle Fajardo
    This document discusses diagnostic tests and microscopic examination of vaginal secretions. It notes that pH testing with narrow range pH paper should be done before examining secretions under a microscope. Normal vaginal pH is 3.8-4.5. Microscopic evaluation includes wet mount examinations of secretions under bright field microscopy to identify and quantify epithelial cells, white blood cells, clue cells, yeast and bacteria present. The document provides details on the appearance and diagnostic significance of various cell types and microorganisms commonly seen during microscopic vaginal examination.

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    PH Should Be Performed Before Placing Into The Saline Commercial PH Test Paper With A Narrow PH Range Is Recommended

    Uploaded by

    Janielle Fajardo
    67 views13 pages
    This document discusses diagnostic tests and microscopic examination of vaginal secretions. It notes that pH testing with narrow range pH paper should be done before examining secretions under a microscope. Normal vaginal pH is 3.8-4.5. Microscopic evaluation includes wet mount examinations of secretions under bright field microscopy to identify and quantify epithelial cells, white blood cells, clue cells, yeast and bacteria present. The document provides details on the appearance and diagnostic significance of various cell types and microorganisms commonly seen during microscopic vaginal examination.

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    This document discusses diagnostic tests and microscopic examination of vaginal secretions. It notes that pH testing with narrow range pH paper should be done before examining secretions under a microscope. Normal vaginal pH is 3.8-4.5. Microscopic evaluation includes wet mount examinations of secretions under bright field microscopy to identify and quantify epithelial cells, white blood cells, clue cells, yeast and bacteria present. The document provides details on the appearance and diagnostic significance of various cell types and microorganisms commonly seen during microscopic vaginal examination.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    67 views13 pages

    PH Should Be Performed Before Placing Into The Saline Commercial PH Test Paper With A Narrow PH Range Is Recommended

    Uploaded by

    Janielle Fajardo
    This document discusses diagnostic tests and microscopic examination of vaginal secretions. It notes that pH testing with narrow range pH paper should be done before examining secretions under a microscope. Normal vaginal pH is 3.8-4.5. Microscopic evaluation includes wet mount examinations of secretions under bright field microscopy to identify and quantify epithelial cells, white blood cells, clue cells, yeast and bacteria present. The document provides details on the appearance and diagnostic significance of various cell types and microorganisms commonly seen during microscopic vaginal examination.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 13

    DIAGNOSTIC TESTS

    pH
    should be performed before
    placing into the saline
    Commercial pH test paper with a
    narrow pH range is
    recommended

    FACTORS

    Contamination of the vaginal secretion with


    cervical mucus, semen and blood

    Ph test help to differentiate the causes of


    vaginitis
    Vaginal pH about 4.5 in women with
    vulvovaginal candidiasis
    Above 4.5 in women with bacterial vaginosis,
    trichomonas, DIV and atrophic vaginitis
    Normal vaginal flora includes a predominance
    of the bacteria lactobacilli, which produce the
    end product lactic acid from glycogen
    metabolism
    Ph value 3.8-4.5

    NORMAL FINDINGS IN VAGINAL


    SECRETIONS

    Appearance: white, flocculent discharge


    Ph: 3.8-4.2
    Amine (whiff) test: negative
    WBCs: 2+
    Lactobacilli: predominant
    Clue cells: absent
    Other cells: absent (except RBCs during
    menses)
    Other organisms other lactobacilli
    subgroups , occasional yeast

    MICROSCOPIC PROCEDURES

    Saline wet mount and KOH mounts are the


    initial screening test and the Gram stain is
    used as a confirmatory examination for
    yeast or bacterial vaginosis

    WET MOUNT EXAMINATION

    Cover slip is placed on the specimen carefully to


    exclude air bubbles
    Slide is examined microscopically using the low power
    and high dry power objective with a bright-field
    microscope
    Using LPO, the slide is scanned for an even
    distribution of cellular components, types and number
    of epithelial cells, clumping of epithelial cells, and the
    presence of budding yeast or pseudohyphae
    Then the slide is examined using the HPO and the
    organism and cells are counted and reported per hpf
    using the criteria

    QUANTITATION SCHEME FOR


    MICROSCOPIC EXAMINATION
    Rare : less than 10 organisms or cells/slide
    1+: less than 1 organism or cell/hpf
    2+: 1 to 5organism or cell/hpf
    3+: 6 to 30 organism or cell/hpf
    4+: > 30 organism or cell/hpf

    TYPICAL CONSTITUENTS FOUND IN VAGINAL FLUID WET


    MOUNT

    Squamous epithelial cell


    WBC
    RBC
    Clue cells
    Parabasal cells
    basal cells
    Bacteria
    Motile Trichomonas vaginalis
    Yeast
    hyphae

    SQUAMOUS EPITHELIAL CELLS


    Measures 25-70 m in diameter
    Exhibit a polygonal flagstone appearance
    Prominent centrally located nucleus about the
    size of RBC and large amount of irregular
    cytoplasm, lacking granularity with distinct cell
    margins
    Originate from the lining of the vagina and female
    urethra and are present in significant numbers in
    the vaginal secretions of a healthy female
    Clumps of epithelial cells are an indication of the
    presence of increased number of yeast

    CLUE CELLS
    Abnormal variation of the squamous epithelial
    cells
    Distinguished by cocobacillus bacteria attached
    in clusters on the cell surface, spreading, past
    the edges of the cell, making the border
    indistinct or stippled. This gives the cell a
    granular, irregular appearance sometimes
    described as Shaggy
    Diagnostic of bacterial vaginosis caused by G.
    vaginalis
    Can also be found in urine sediment

    WBC
    Measure 14-16m in diameter
    Exhibit a granular cytoplasm
    PMNs
    Present in rare to scanty number in vaginal
    secretions
    Greater than 3+ WBCs in vaginal secretion
    suggest vaginal candidiasis, atrophic
    vaginitis, or infections with Trichomonas,
    Chylamydia, N. gonorrhoeae, Herpes
    complex

    RBC
    Smooth
    Non-nucleated biconcave disk measuring
    approximately 7-8m in diameter\distorted
    in vaginal specimen
    Not usually seen
    Can be confused with yeast cells and are
    distinguishes from yeast cells by KOH,
    which will lyse the RBCs but allow the yeast
    cells to remain intact

    PARABASAL CELLS
    Round to oval
    Measures 16-40m in diameter
    NC ratio 1:1-1:2 with marked basophilic granulation
    or amorphic basophilic structures blue blobs
    Located in the luminal squamous epithelium of the
    vaginal mucosa
    Rare to find ( but less mature cells may be found if
    the patient is menstruating and in post menopausal
    women)
    Increase number of parabasal cells, if present with
    large number of WBCs can indicate desquamative
    inflammatory vaginitis

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